日本政府文部科学奖学金留学生申请书-YonseiGSIS

1、application for japanese government （monbukagakusho：mext） scholarship日本政府（文部科学省）奨学金留学生申請書research students for 2012 （研 究留 学生）instructions （記入上注意）1 the application should be typed if possible, or neatly handwritten in block letters.（明瞭q記入丁5 二匕）2 numbers should be in arabic numerals.（数字i*算用数字总用二匕）3 ye

2、ars should be written using the anno domini system.（年号西曆4 proper nouns should be written in full and not abbreviated（固有名詞肚歹'cie式才e名称l, 一切省略匕）* personal data entered in this application will only be used for scholarship selection purposes, and contact intormation such as e mail addresseswill only

3、 be used for forming related human networks after the student returns home and for sending of information by the japanese government.）（木中請書【二記個人悄報木奨学金。魁环讣乙使用王力"i 特（r e-mail t kux等連絡先帰国後関係者卜乃一夕总作召二七及/必嬰広応匕日本政府0各種情報总送信歹召以外!使用lziv）（sex）1 name in full in native languageomalc （另）（姓名（自国語）（family name

4、）（first name）（middle name）female（女）in roman block capitals（口一p 字）（marital status）（family name）（first name）（middle name） single （未婚）（write your name exactly same as is printed in your passport）married（既婚）2 nationality探 possesion of japanese nationality cyes, 1 have. （iiv9fas【e a passixirt sized photo

5、graph or digital image taken within the past 6 months write your name and nationality in block letters on the back of the photo.（4. 5cm x 3. 5cm photo）（写真（4. 5cmx 3. 5cm）（国 籍） dno, 1 don't have it.（vxl/nx.）3. date of birth 月曰）19year （年） month （月） day （日） age（as of apr订 1,2012）年齢（2012 年4 月 1 日現在）

6、4 present status with the name of the university attended or employer（現職（在学大学名又肚勁務先名求疋記入丁召二匕）present address and telephone number,（現住所及旷電話，t 了、x入番号,現住所（present address）:facsimile number, e-mail addresse-mail 7電話番号/fax 番号（telephone/facsimile number）:e-mail address:* if possible, write an e-mail addre

7、ss that can be used lor periods including the time before you come to japan, your stay in japan and the period after you return home（可能卞限9、渡日前日本留学中帰国後使、続予想e-rnail t記入6 . field of specialization studied in the past （be as detailed and specific as possible）（過去人専攻5専門分野（左吉具体的人詳細忆苦 二匕）7 educational backg

8、round （学歴）name and .address of school（学校名及<5所在地）year and month of entrance and completion （入学及/卒業年ji）amount of time spent at the school attended （修学年数）diploma or degree awarded, major subject（学位資格，再攻科目） when taking leave of absence the period and reason（休学5場知士乞co期間理由）elementar>- education （初等教

9、育）name（学校名）from（人学）years （年）elementary school （小学校）location（所在地）to（卒業）and months （月）secondary education （中等教育）name（学校名）from（入学）years （年）1 -ower secondary school （屮学）location（所在地）to（卒業）and months （月）name（学校名）from（人学）years （年）upper secondaiy school （高校）location（所在地）to（卒業）and months （月）1 ligher educati

10、on （高等教育）name（学校名）from（入学）years （年）undergraduate level （大学）location（所在地）to（卒業）and months （月）name（学校名）from（入学）years（年）graduate level （大学院）location（所在地）to（卒業）and months （月）total years of schooling mentioned above （以上总通算全学校教佇修学年数）yearsas of apr订 1,2012（2012年4月1日現在）（年）* if the blank spaces above are not

11、 sufllcient for the information required, please attach a separate sheel.（注）上櫚人書吉吉打八、埸合uii,適当肚別紙広記入添付to）8 . state the titles or subjects obooks or papers （including graduation thesis authored by the applicant）, if any, with the name and address of the publisher and the dale of publication.（著書.論文（卒業論

12、文总含心）力绥tu丈乞題名，出版社名，出版年月曰，出版場所总記t9 employment record - begin with the most recent employment, if applicable（職!塑）name and address of organization（勤務先及杉所在地）period of employment（勤務期間）position（役職名）type of work（職務內容）fromtofromlo10. japenese language proficiency* evaluate your level and insert an x where a

13、ppropriate in lhe following blank space.（日本帝能力总自己評価7 xl,該当欄q x印总記入才召二匕）excellent（優）good （良）fair 何）poor （不可）reading （続t?能力）writing （書 < 能力）speaking（話才能力）11. foreign language proficiency: evaluate your level and insert an x where appropriate in the following blank space.（外国語能力总自己評価7 x,該当欄q x印总記人刁p二

14、匕）excellent（優）good （良）fair（可）poor （不可）english（英語）french （仏詰）german （独詰）spanish（西語）12. have you been awarded a japanese government （monbukagakusho） scholarship in the past? if so, please spccily the period, the name of the university, etc（過去人国費留学生広採用力、。笳召玄龙，乞期間受人大学名等总記人）i ） yes, i have（>6）period-

15、university- ii） no, i have not.（壮'）13. accompanying dependents （provide the following information if you plan to bring any family members to japan.）同伴家族欄（渡日歹召埸合，同伴予定家族力"、召埸合人記入歹召二七。）* all expenses incurred by the presence of dependents must be borne by lhe grantee hc/she is advised to take

16、into consideration various difficulties and the great expense that will be involved in finding living quarters therefore, those who wish to be accompanied by their lamilies are advised to como alono flsl and lcl their dependents come after suitable accommodation has been found（注）肚指同伴者i乙必要朮経留学生負担家族用宿

17、舎相当困難賃貸料非常i乙割高 承知留学生ntt単身宅来日適当卞宿舎总於orttt後，家族总呼杉寄/name（氏名）relationship僦柄）age（年齢）14. person to bo notified in applicant* s home country in case of emergency：（緊急際（7）母国（7）連絡先）i ） name in full"（氏名）ii） address* with telephone number, facsimile number, e-mail address（住所：爼話番号，刁丁、'小久番号及疔e-mail t kux

18、总記入6二匕）現住所（present address）:宦話番号/fax 番号（telephone/facsimile number）:e-mail address:hi） occupation：（職業）iv） relationship：（本人上関係）15. immigration records to japan （11 本入7）渡航記録）date （日付）purpose （渡紈目的）fromtofromio（1 understand and accept all the matters stated in the application for japanese government（mo

19、nbukagakusho:mext） scholarship for 2012, and hereby apply for this scholarship（私n2012年度日木政府（文部科学省）奨学金留学生募集要項記項总歹y-c了解。疋中請u求丁）date of application：（申請年月日）applicant* s signature：（申請者署名）applicant* s name（in roman block capitals）:（申請者氏名）（别紙）専攻分野及"研究計画field of stud、 nd study programfull name in native language（姓名（自国7吾）（family name）（first name）（middle name）nationality（国籍）pro